Investing in Midwifery to Ensure Respectful Maternity Care at the Aberdeen Women’s Centre

With just 1 midwife for every 1000 live births, Sierra Leone needs a twelve-fold increase in its midwifery workforce to ensure full coverage of maternal and newborn health services. It is tempting to focus exclusively on training new midwives, but existing midwives also require attention. They can only function effectively if their own professional needs are met. The Aberdeen Women’s Centre in Freetown, Sierra Leone, provides an example of what a midwife-led maternity unit can look like: where midwives have the support they need to do their jobs well, and where mothers and babies therefore receive respectful, high-quality services.

An important new article in the Midwifery’s forthcoming Millennium Development Goals special issue describes in detail a practical example of how we can “invest in midwives” and equip them to offer competent, compassionate, and respectful care to expecting and delivering mothers. “Striving for excellence: Nurturing midwives’ skills in Freetown, Sierra Leone” recounts how the Aberdeen Women’s Centre launched a maternity unit focused on supporting midwives to offer exemplary care.

The Aberdeen Women’s Centre is a private clinic that was founded in 2005 to provide surgical repair to women who suffer from obstetric fistula. The Centre’s focus on fistula treatment remained constant until one of its own staff died in childbirth. In the wake of this loss, the clinic’s leaders began to consider expanding their mandate. They saw an opportunity to offer quality maternity care to women who would be unable to pay, thereby preventing the occurrence of new fistula cases and reducing maternal mortality. With support from the Gloag Foundation and U.S. Agency for International Development (via EngenderHealth’s Fistula Care project), the Aberdeen Women’s Centre opened its midwife-led maternity unit in May 2010.

The Centre provided ongoing in-service education and supportive supervision for its staff midwives. Expert midwife volunteers served as mentors, modeling a commitment to quality, evidence-based care. Through training and routine review of near-misses, the Aberdeen Women’s Centre midwives have developed professionally and are poised to become future leaders for midwifery in Sierra Leone.

Meanwhile, these midwives have offered an excellent level of care to delivering mothers and their newborns. In the first two years of the maternity unit’s services, its staff assisted 2,076 births, with better-than-expected health outcomes for mothers and babies.

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The posts on this blog do not necessarily reflect the views of the Maternal Health Task Force. Our objective is to provide a platform for our Editorial Committee and other experts to post a myriad of data and evidence, as well as opinions/views that exist in the field which will contribute to expanding the maternal health dialogue.